Why most people with hearing loss don't use hearing aids
Before going out with friends, Jacqueline Cummine used to write out a list of questions about a topic—like a football game—to use as a conversation starter. That way, she knew she'd be able to at least take part, even if she couldn't hear everything.
It was a way of coping with chronic childhood ear infections that resulted in hearing loss. Cummine didn't want anyone to know she struggled to catch even snippets of conversation.
"I was embarrassed by my hearing loss and tried to hide it for many years," she said.
That changed when she was finally fitted with hearing aids in her early 30s and she tuned into a better world.
"All of a sudden I could remember things better, I could have a conversation, my word-finding skills took off."
Cummine, a University of Alberta neuroscientist in the Faculty of Rehabilitation Medicine, wasn't the least bit worried about wearing the tiny devices tucked behind her ears; in fact, she was excited to get them in 2013.
"I really was hoping to have my hearing improved and was willing to do almost anything."
But according to one of her fellow researchers, she's an exception to the rule. About 80 per cent of Canadians who know they need hearing aids aren't using them, said audiology expert Bill Hodgetts, who is working with Cummine on studying why.
With an aging population, the reluctance to use hearing aids is a concern, he believes. One in 10 Canadians have hearing loss, and "a large percentage of those are over age 65."
When people don't take advantage of the benefits hearing aids offer, they lose some quality of life by missing out on human connections, he said.
"When you have hearing loss, you start to withdraw socially. You often don't contribute to conversations at all, because you don't want to be embarrassed. People often feel like they're being rude if they don't hear someone call their name, or if they have to ask someone to repeat themselves."
Cummine found herself in that dilemma, avoiding conversations if she could. "I'd find myself asking 'what?' over and over."
Why people don't wear them
For several reasons, it's very easy to get turned off the idea of wearing hearing aids, Hodgetts admitted.
"Some people expect restored hearing, but hearing aids still go through a damaged system," he noted. "Their expectations of the technology are often too high, and when those expectations aren't met, people become disenfranchised, stop using them and tell everyone else it doesn't work," he said.
It's important to understand that hearing aids aren't designed to restore lost function—delicate hair cells in the ear damaged by noise, age or medications can't just be repaired. Instead, they use tiny directional microphones and a lot of advanced processing to help minimize distracting background noise.
"They maximize your ability to hear who's talking to you," Hodgetts explained.
Stigma is another deterrent.
"Hearing aids can make people feel that they're old. They also have difficulty about advocating for their hearing—they feel nobody will understand."
And the cost of hearing aids, which ranges from $2,000 to $7,000 per ear, doesn't help, said Hodgetts, who is conducting research on gaps in coverage through health-care and insurance plans.
"If you're retired and have a fixed income, there's insufficient help financially."
But despite the barriers, people who've been diagnosed as needing them should try using hearing aids.
Take time to get it right
"Keep an open mind and don't give up," said Hodgetts. "While they're not perfect, they do improve a person's listening performance."
Persistence is important in successfully adjusting to the technology, he added.
"It's a slow process you have to work through, but it's your right to spend as much time with an audiologist as you need to. Hearing aids need counselling, support and time, just as a prosthesis would."
There are plenty of manufacturers with multiple lines of hearing aids, with most offering a trial period, so there are more options than people may realize, Hodgetts noted.
Cummine struggled for the first six months she wore hearing aids before switching to a different kind that worked better for her.
"We got it to the point where it was just incredible," she said.
It's important for people with hearing aids to find their voice when asking for understanding, from friends, family and in public places.
"If one person in the family has hearing loss, everyone needs to adjust and to be more forgiving," Hodgetts said. "It's OK to ask people not to talk to you when they're out of the room or while they're running water or while the radio is on. Ask to have the music turned down in a restaurant. It can really empower you as an individual with hearing loss."
For Cummine, who was once reluctant to tell people she had hearing loss, it wasn't easy to get to where she is now, but she's glad she made the effort.
"I am no longer shy about my hearing aids. I wear my hair up all the time, I have no issues if people ask me about them. I now feel so grateful about where I am, and the journey to get there is part of that story, so I want to encourage people to keep trying."
When to get your hearing checked
- It's a good idea to see an audiologist if any of these situations apply to you:
- You find yourself having to listen intently to hear someone speak.
- You can hear fine in quiet circumstances, but it becomes suddenly difficult in noisy environments like restaurants.
- There's a family history of hearing loss.
- There's a consistent ringing, buzzing or hissing sounds in the ears, a condition called tinnitus.
- Someone close to you says you don't hear very well.
- The TV or radio volume is different for you than everyone else.
Seeing an audiologist doesn't necessarily mean you'll need hearing aids. "But they can check for medical issues, they can tell you where you're at with your hearing and, if necessary, they can begin the counselling process," said audiology expert Bill Hodgetts.